title: Natural course of scoliosis in proximal spinal muscular atrophy type II and IIIa: descriptive clinical study with retrospective data collection of 126 patients.
abstract: BACKGROUND
  Progressive scoliosis, pelvic obliquity and increasing reduction of pulmonary function are among the most significant problems for patients with SMA type II and SMA type III once they have lost the ability to walk. The aim of this study was to examine and document the development and natural course of scoliosis in patients with spinal muscular atrophy type II and IIIa.
  
  
  METHODS
  For the purposes of a descriptive clinical study, we observed 126 patients, 99 with SMA II and 27 with SMA IIIa and the data of scoliosis, pelvic obliquity and relative age-dependent inspiratory vital capacity were evaluated.
  
  
  RESULTS
  Scoliosis and pelvic obliquity were regularly observed already in children under 4 years old in the group with SMA II. The severity and progression of both conditions were much more pronounced in the SMA II group than in the IIIa group. There was already a distinct reduction in relative vital capacity in the group of 4- to 6-year-olds with SMA II.
  
  
  CONCLUSIONS
  The differences between the two SMA types II and IIIa described in this study should be taken into consideration when developing new treatments and in management of scoliosis in the childhood years of these patients.
authors.affiliation: Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Rathsberger Str, 57, D-91054 Erlangen, Germany. a.fujak@t-online.de.
authors.forename: Albert
authors.initials: A
authors.lastname: Fujak
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Raab
authors.forename: Alexander
authors.initials: A
authors.lastname: Schuh
authors.forename: Silvia
authors.initials: S
authors.lastname: Richter
authors.forename: Raimund
authors.initials: R
authors.lastname: Forst
authors.forename: Jürgen
authors.initials: J
authors.lastname: Forst
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001696:Biomechanical Phenomena; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D018450:Disease Progression; D006801:Humans; D007223:Infant; D007320:Inspiratory Capacity; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology; D009043:Motor Activity; D010388:Pelvis / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D014897:Spinal Muscular Atrophies of Childhood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D055815:Young Adult